30 September 2015 Nursing and Midwifery Council, 2 Stratford Place, Montfichet Road, London, E20 1EJ

Transcription

1 Conduct and Competence Committee Restoration Hearing 30 September 2015 Nursing and Midwifery Council, 2 Stratford Place, Montfichet Road, London, E20 1EJ Name of registrant: NMC Pin: Paul Baah 96I4770E Part(s) of the register: Registered Nurse Sub Part 1 Mental Health- 30 August 1999 Specialist Practitioner Community Mental Health Nursing 29 November 2003 Area of registered address: Type of case: Panel members: Legal Assessor: Panel Secretary: England Conviction John Matharu (chair, lay member) Carol Sanders (registrant member) Kay Grindell (lay member) Alexander Jacobs Tarun Sharma Representation: Nursing and Midwifery Council (NMC): Represented by Paul Andrews, Counsel, instructed by the NMC Regulatory Legal Team Mr Baah: Outcome: Mr Baah was present and represented by, Elizabeth Wheeler, Counsel, Charter Chambers Application Granted Page 1 of 12

2 Background At a substantive hearing which concluded on 13 May 2008, a panel of the Conduct and Competence Committee found a charge proved against you, by your own admission. That panel also found that your fitness to practise was impaired by reason of your conviction. It directed that your name should be removed from the Nursing and Midwifery Council (NMC) Register. This panel is fully aware of the facts that gave rise to the substantive proceedings whilst you were working as a registered nurse. The charge you faced at the substantive hearing, and which was found proved, was as follows: That you on 9 January 2006 were convicted at Wimbledon Magistrates Court of assaulting Ms 1, thereby occasioning her actual bodily harm, and on 31 January 2006 were sentenced to six months imprisonment; And, in light of the above, your fitness to practise is impaired by reason of your conviction. The panel at that substantive hearing found that your fitness to practise was impaired. The reasons for this finding were: The panel note Mr Baah s acceptance that this conviction impairs his fitness to practise and we have no hesitation in agreeing with him. Our reasons are as follows. In our judgment this was a serious offence of domestic violence against his wife committed in front of their children. It resulted in actual albeit relatively minor bodily harm to his wife and warranted an immediate custodial sentence. The NMC s Code of Professional Conduct states that the Registrant must act in such a way as to justify the public trust and confidence in the profession and must adhere to the laws of the land. Mr Baah breached these duties under the Code. As a result, his fitness to practise is impaired by virtue of his conviction Page 2 of 12

3 That panel decided to remove your name from the Register with immediate effect. The reasons for imposing a striking-off order were: We have had regard to the Indicative Sanctions Guidance of the NMC and the principle of proportionality of sanction. The panel considers the facts of the case to be too serious for no action to be a realistic option. The [panel] next considered whether to impose a Caution Order. The panel noted that Mr Baah was of previous good history and this was an isolated incident. We note that there has been no repetition since that. Mr Baah has remarried and maintains contact with his children through his ex-wife. Nonetheless, we were not persuaded that Mr Baah has real insight into the behaviour into this incident and note that there was no early admission of the facts. While we have no doubt that prison was a salutary experience for him, no evidence has been submitted of appropriate rehabilitative or corrective steps having been taken, such as counselling or anger management course. Further, in our judgment, and significantly, Mr Baar [sic] has not submitted any references or testimonials, whether from employers or colleagues. While we note the facts did not result in patient harm, it did result in physical harm to his then wife who required hospital treatment. Taking into account all these matters and balancing the rights of the Registrant and our duty to declare and uphold proper standards of conduct, the panel is not persuaded that a Caution Order is a sufficient sanction in this case. The panel next considered a Conditions of Practice Order as the facts here do not concern a competence issue and Mr Baah is not currently engaged with the nursing employer, we do not think such an Order can be appropriate or sufficient. Given our view as to the seriousness of this conviction, the panel does not think that a Suspension Order is a sufficient sanction. The panel has concluded that the circumstances here are fundamentally incompatible with Mr Baah remaining a registrant. The behaviour was a serious departure from the standards set out in the NMC s Code of Professional Page 3 of 12

4 Conduct. We conclude the confidence in the Council and the profession would be undermined if Mr Baah was not struck off. For those reasons a Striking Off Order is, in our judgment, the appropriate and proportionate sanction in this case... Determination on application for restoration You have made an application to be restored to the Register, pursuant to Article 33 of The Nursing and Midwifery Order 2001 (the Order), which states: 33. (1) Where a person who has been struck off the register by virtue of an order made by a Practice Committee or the court wishes to be restored to the register, he shall make an application for restoration to the Registrar. (5) The Committee shall not grant an application for restoration unless it is satisfied, on such evidence as it may require, that the applicant not only satisfies the requirements of article 9(2)(a) and (b) but, having regard in particular to the circumstances which led to the making of the order under article 29, 30 or 38, is also a fit and proper person to practise the relevant profession. This is your first application for restoration. At this hearing the panel may reject your application or it may grant your application unconditionally. It may grant your application subject to your satisfying the requirements of Article 19(3) and it may make a conditions of practice order. The panel noted your written submission within your NMC application for restoration form; within that document you stated the following: My main source of inspiration to become a nurse came from an innate desire to help people and care for them in times of need. I am also a person who thrives on being challenged and always have new goals to achieve, so nursing suits me as a few other careers offer as much diversity and learning opportunities, hence my pathway to mental health nursing as a branch. It was also very rewarding to feel that Page 4 of 12

5 my input, no matter how small, had a positive effect on the lives of those I was caring for. In view of the above, I am always eager to learn new ideas and skills to help impact my personal and professional development. My career as a nurse was on an upward trajectory, practising in an area that interested me and gave me tremendous personal fulfilment. Unfortunately all of that was brought to a sudden end because of a personal moral and ethical failure. As a consequence, I have been away from a profession I am passionate about for too long, I will say. Due to my personal, moral and ethical failure, the NMC had no option but to terminate my registration. My conduct had clearly violated the Council's code of professional conduct. I understand that though what happened could be said to be in the personal or private arena, it is also self-evident that it reflected badly on my standing as a professional nurse and the standard of conduct expected of me as a registrant. Being away from the profession I dearly love, I have had opportunity to reflect on my life. I have made a significant journey in developing a much more reflective attitude to life and the management of offence, irritation, annoyance and anger. I have learnt that in the real world one would encounter offence such as conduct of others which causes one to be annoyed and angry, these are inevitable life realities. The challenge is how you handle them in a constructive way so that personal development towards maturity occurs. These are the lessons I have learnt and I can assure the Council that if reinstated to the register, the lessons learnt will be taken forward and will definitely inform my future conduct. To mention a few, I have re-visited reflective practice, anger management, ethical principles of nursing, communication skills, multi-disciplinary team working and assertiveness skills, relating these to my experiences of recent years. Clear lessons have been learnt which would impact in a positive way on my future conduct. Being away from the profession I am passionate about has created for me a void. I do feel unfulfilled, missing a clear purpose and meaning. I am asking for the Council to make a decision in my favour by reinstating me on the professional register. I can assure the Council that I will be returning to nursing a changed man, a more reflective, considerate and wiser man. I can also assure the council that Page 5 of 12

6 there is no conceivable likelihood that the conduct which led to me being removed from the register will ever repeat itself again. I wish to thank the NMC for giving me the opportunity to formally apply to be reinstated as a registered nurse. I am looking forward to returning to the profession I love and hope the Council would accept my plea and make a decision in my favour The panel further noted the positive references within your application for restoration on to the register form; these were written by Mr 1, Mr 2 and Mr 3. Evidence In additional support of your application for restoration on to the Register, Ms Wheeler, on your behalf, provided the panel with bundle of documents in support of your application. This consisted of: Your detailed reflective piece Training certificate for completing a course in Communication Skills, Assertiveness Skills, Anger Management and Multi-disciplinary team working, dated 1/11/2013. Training certificate for completing a course in Reflective Practice, Clinical Supervision, NMC Code of Professional Conduct and Ethical Principles in Nursing Practice team working, dated 4/10/2013. Certificate of attendance for completing a one day Anger Management Workshop, dated 14/09/2015 A further positive reference by Mr 1, registered nurse. A further positive reference by Mr 2, registered nurse. A further positive reference by Mr 3, Reverend. A positive reference by Mr 4, registered nurse. A positive reference by Mr 5, registered nurse A positive reference by Mr 6, registered nurse. A positive reference by Mr 7, Technical Officer. A positive reference by Ms 2, registered nurse. Page 6 of 12

7 A positive reference by Ms 3, registered nurse. A hand written document outlining the jobs that you have applied for in a care environment. A recent example of a job application form, where you have disclosed your past conviction. The panel heard evidence from you under oath. You first outlined your career history. You stated that in 1999 you qualified as registered nurse in the United Kingdom. After qualifying, you first worked as a mental health nurse in the Forensic Unit at Chase Park Hospital. Shortly after, you changed employers and worked at Ealing General Hospital in the Forensic Unit. In 2001 you again changed employers and worked at South West London St Georges NHS Trust, initially as a Mental Health Nurse and thereafter as a Community Nurse. You stayed in this employment for a period of five years and up until your conviction. You stated that you have never been convicted prior to your conviction in 2006 and have had no convictions thereafter. You stated that the substantive panel s decision to strike you off the Register was the correct decision. You said that being struck-off the Register gave you the opportunity to reflect on your actions. You stated that after being struck-off you gained employment as a bus driver and then you worked as a minicab driver, which is still your current employment. You stated that you have applied for roles in the care environment but have been unsuccessful. Page 7 of 12

8 You stated that since the incident which led to your conviction, you have not lost your temper. You stated that you were sorry about your past actions and assured the panel that you will never repeat your past behaviour. You stated that you have benefited from the anger management courses which you attended. You stated that you have learnt techniques of how to avoid anger and situations which may cause you anger. You said that peace is the key and anger is never the solution to any problem. You stated that you have come across others who have had anger issues and you shared your experiences with them and tried to assist them in managing their anger. You stated that you wish to be an ambassador to others that have been in your past situation, and you would like to coach them on how to overcome their anger. You said you would be open an honest with any future colleagues within the nursing profession by informing them about your past conviction. You stated that you hoped the public would forgive you for your past actions and that they would realise that you have now positively changed and reflected on your actions. In the event that you are restored on the Register, you stated that you were aware that you would need to complete a Return to Practice Course. You stated that you have enquired about this course with Greenwich University and Luton Hospital. You explained the references that you have provided and how you knew the individual referees. You concluded by stating that you are of good character, that you are very sad for your actions, that you would never repeat your past actions. You again apologised to the panel and to the NMC. Page 8 of 12

9 The panel then heard evidence from Mr 1, on your behalf. Mr 1 stated that he is a registered nurse and that he has known you personally since He said that you influenced him to become a nurse and that during his nursing education you were like a mentor to him. Mr 1 stated that he was fully aware of the incident which led to your conviction. He said that your past actions were out of character and that he has never seen you be violent or angry. Mr 1 stated that your past colleagues had never said anything bad about you as person or in relation to your nursing skills. Mr 1 stated that you are a good, kind and caring person. You have reflected on your past mistakes and you are highly unlikely to repeat such behaviour. He stated that you should be given an opportunity to return to nursing. Panel s decision In considering your application the panel has taken account of all of the documentation before it, including the references and reflective pieces that you have submitted. It has taken particular account of your oral evidence, Mr 1 s oral evidence and carefully considered the closing submissions made by Mr Andrews, on behalf of the NMC and by Ms Wheeler, on your behalf. The panel heard and accepted the advice of the legal assessor. The panel reminded itself of the relevant parts of Article 33 of the Nursing and Midwifery Order 2001 (the Order) as set out above. The panel had regard to the case of Balamoody v Nursing and Midwifery Council [2009] EWHC 3235 (Admin), and in particular the following paragraphs: Page 9 of 12

10 Para 12: There are two principal issues which they have to consider before restoring a practitioner s registration. The first is whether the practitioner is safe to practise. The second is whether the public s trust and confidence in the professions may be undermined by restoration of the practitioner. Para 39: The question the panel had to answer had by Article 33 (5) to be informed by the particular circumstances that had given rise to the removal from the register. Para 40: The registrant had insight into that which had happened in the past as a surrogate for asking the question which their minds should really and centrally have addressed; that is, whether he was potentially safe in the future. Para 44: The fundamental question is whether the practitioner is safe. In reaching its decision, the panel has considered a number of matters including: Whether you are capable of safe and effective return to practice; Whether it is satisfied that you are a fit and proper person to practise; The protection of the public; The maintenance of public confidence in the profession and declaring and upholding proper standards; Whether you have insight into the conduct which brought about you being struck off the register; What steps you have taken to remedy your past behaviour. The panel noted that the burden was upon you to satisfy the panel that you are capable of safe return to practice. The panel recognised the impact that removal from the Register has had on you. The panel listened carefully to your evidence. You were extensively questioned today regarding your actions and how you would prevent a similar situation occurring. The Page 10 of 12

11 panel determined that you were a credible witness and you responded honestly and positively to questions that were put to you. The panel also found Mr 1 to be a reliable and credible witness. The panel noted that you have submitted numerous references from registered nurses. Your referees speak very highly of you and all confirm that you are of good character. The panel was reassured by Mr 1 s evidence that you a person of otherwise good character. You have expressed remorse and, in response to panel questions, were able to articulate insight into your past misconduct and the detrimental effect it had on the public perception of the profession. You fully accepted your past wrongdoings and acknowledged that you were accountable for your actions. The charge found proved against you was serious. The panel was aware that its primary consideration in hearing your application was to determine if you are currently a fit and proper person to resume practice as a registered nurse. The panel was mindful that these incidents occurred over 9 years ago with no evidence of any repetition. Furthermore, in the panel s view it is highly unlikely that these incidents would be repeated. The panel noted that prior to the incidents giving rise to the striking-off order there were no complaints regarding your professional performance or behaviour. You feel you have much to offer with regard to nursing. The panel was of the view that the incident which led to your conviction arose from a specific set of circumstances and that you had acted out of character. The panel considered, on the basis of your insight and remorse since being struck-off, that it was unlikely that you would repeat such conduct in the future or fall below the standards of a registered nurse in this regard. The panel considered that you have learnt from your past wrongdoings and acknowledged your desire to return to being a registered nurse. Page 11 of 12

12 The panel was satisfied that the public interest has been met by your conviction, sentencing and the striking off order imposed by the substantive panel. The panel considered that there was a public interest in allowing you to be restored back on the Register based on views expressed by other registered nurses that you were a safe, caring and competent nurse. The panel is satisfied that for the above reasons you are now a fit and proper person to be restored to the Register, subject to satisfying the Registrar of the matters prescribed in Article 9 (2) and 19 (3) of the Order, and until you have successfully completed an NMC-approved return to practice course. The panel determined that the public interest in the upholding of standards and maintenance of confidence in the profession would not be undermined if you were restored to the Register. The panel carefully considered whether to restore you to the Register with or without conditions. Having regard to all the circumstances in this case, in particular, the panel s conclusion that the public interest considerations in this case have been met, it was satisfied that the public interest can be sustained by permitting you to be restored to the Register without conditions. The panel accordingly directs the Registrar under Article 33(7) and in accordance with Article 33(6) of the Order to restore your name to the Register subject to you fulfilling the requirements as to additional education or training and experience as the Council has specified under Article 19(3) of the Order as they apply to you. This decision will be confirmed to you in writing. That concludes this determination. Page 12 of 12